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High CV risk factor burden in young adults is a ‘smoldering’ crisis

High CV risk factor burden in young adults is a ‘smoldering’ crisis


New data show that the burden of most cardiovascular (CV) risk factors is high and increasing among young adults aged 20 to 44 in the United States.

In this age group, the prevalence of diabetes and obesity has increased over the past decade, the prevalence of hypertension has not improved, and the prevalence of hyperlipidemia has decreased.

Dr. Rishi Wadela

But treatment rates for cardiovascular risk factors in young adults are “surprisingly” low, said Rishi Wadera, M.D., Ph.D., director of research at Beth Israel Deaconess Medical Center in Boston and Harvard Medical School. rice field.| Medscape Cardiology.

The findings are “deeply alarming. We are witnessing a smoldering public health crisis. Early onset of these risk factors leads to a higher lifetime risk of heart disease and life could threaten,” Wadela added.

The study will be presented March 5 at the 2023 American College of Cardiology (ACC) Scientific Sessions/World College of Cardiology (WCC) Simultaneous release of jam.

The burden of CV risk factors in young adults is “unacceptably high and increasing,” write the paper’s co-authors. jam editorial.

Dr. Norina Allen and Dr. John Wilkins said: “Now is the time to take proactive preventive measures for young adults. Without immediate action, heart disease will continue to increase, placing a burden on patients, families and communities. It will take a lot of time,” he said. Doctor of Medicine, University of Chicago Feinberg School of Medicine.

Preventing a tsunami of heart disease

Findings are based on 12,294 US adults aged 20-44 years (mean age 32 years, 51% women) who participated in the National Health and Nutrition Examination Survey (NHANES) cycle from 2009-2010 to 2017-March 2020. Derived from a cross-sectional study. .

Overall, the prevalence of hypertension was 9.3% in 2009-2010 and increased to 11.5% in 2017-2020. Diabetes prevalence increased from 3.0% to 4.1%, and obesity prevalence increased from 32.7% to 40.9%. The prevalence of hyperlipidemia decreased from 40.5% to 36.1%.

Black adults consistently had higher rates of hypertension during the study period, 16.2% in 2009-2010 and 20.1% in 2017-2020, compared with Mexican-American adults (6.5%-9.5%). ), other Hispanic adults (4.4% to 10.5%), and Mexican-American adults (4.3% to 7.5%).

Equally concerning, only about 55% of young adults with hypertension receive antihypertensive medications, and only 1 in 2 young adults with diabetes receive treatment. “These low rates are partly because many young adults are unaware of their diagnosis,” he noted.

The NHANES data also show that the proportion of young adults receiving treatment for hypertension and achieving blood pressure control did not change significantly over the study period (65.0% in 2009-2010; 74.8%). Glycemic control in young adults receiving treatment for diabetes remained suboptimal throughout the study period (45.5% in 2009-2010 and 56.6% in 2017-2020).

“The fact that blood pressure control and blood sugar control are so poor is really worrying,” said Jeffrey Berger, M.D., Ph.D., director of the Center for Cardiovascular Disease Prevention at NYU Langone Heart, who was not involved in the study.| Medscape Cardiology.

“Even in lipid control, it’s a little better, but still only about 30% to 40%, so I think we as a society have a way forward,” Berger said.

double the screening

Wadhera said: A tsunami of cardiovascular disease can be avoided in the long run.

“It’s very important that young adults talk with their health care providers about whether and when they should be screened for high blood pressure, diabetes, and high cholesterol,” Wadela added.

One problem, Berger said, is that young people often have a “superman or superwoman” look and don’t realize they’re at risk for these diseases. Studies like this “support the idea that you’re never too young to check it out.”

As a cardiologist who specializes in preventing cardiovascular disease, Berger said he sometimes hears patients say, “I never need a cardiologist,” or “I hope I never need a cardiologist.” .

“My answer is, ‘There are different types of cardiologists.’ Seeing a cardiologist with a focus on prevention before a problem occurs really helps a lot of people.” I think,” he said.| Medscape Cardiology.

“As a system, medicine is very good at treating patients with a wide variety of illnesses. I think we need to improve in terms of preventing some of these problems,” Berger said. added.

Allen and Wilkins wrote in an editorial, “The foundations of cardiovascular health begin early in life. emphasizes the importance of focusing on the prevention of

This study was funded by a grant from the National Heart, Lung, and Blood Institute. Wadhera has been a consultant for Abbott and her CVS Health. Wilkins receives personal fees from her 3M. Berger has not disclosed any related financial relationships.

American College of Cardiology (ACC) Scientific Session/World Congress of Cardiology (WCC) 2023: Abstract 1044-09.

jamPublished online on March 5, 2023. full text, editorial

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